It is extremely doubtful whether a patient diagnosed with malignant narcissism will respond positively to analytic therapy, particularly group therapy. The prospects for recovery are not favourable because a patient with malignant narcissism has a tendency to destroy everything that is good, including the therapeutic relationship, and this destructiveness can seriously undermine the treatment of other patients. Nevertheless, in this article a case is presented that illustrates that long-term analytic in-patient treatment can be successful. The theoretical background to the diagnosis is outlined so that readers will be able to understand the nature of the treatment.